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Fall and Injury Prevention
Slips and falls can happen to anyone at any time. But, there are factors that do increase risk and ways to help prevent them.
We all try to take extra precautions on icy surfaces during winter, such as adding sand to steps and sidewalks and wearing footwear with good traction outdoors. It is important to remember, however, slips can happen inside the home too.
Imagine going to meet a friend at their house to pick them up. Your friend has been on their own for a few years. They seem to be managing, with your help and support from other friends and family. What you anticipate will be a pleasant start to a routine social call turns into an emergency, or a tragedy, when you find the person on the floor, alive, but apparently unable to move. You call for assistance immediately. As you wait for help to arrive, questions linger: How did this happen? Could it have been prevented?
The estimated risk of fall for Canadians aged 65+ is 33% (1 in 3). Regardless of fall type, those who fall, typically do so during some activity, predominately walking (whether on snow, ice or some other surface). The most common sites of an injury according to the Second Report on Seniors Falls in Canada are the shoulder and/or upper arm, followed by the knee and/or lower leg. The most common types of injuries are fractures (35%) or soft-tissue strains (muscles) or sprains (ligaments). It is important to remember, however, that there are a wide range of other environments in which one might fall, and injuries that may be sustained, including concussion and other traumatic brain injuries. It should be noted that falls account for 85% of all injury-related hospitalizations for Canadians aged 65+.
Ice, Snow, Illness and Medications
A variety of intrinsic (unique to the individual) and extrinsic (environmental, situational) factors contribute to the risk of falling. Risk factors have been divided (Public Health Agency of Canada, 2014) into 4 sub-categories: biological (illness, whether acute or chronic), behavioural (ie: improper use of assistive devices, alcohol use, diet, risk-taking behaviours), social and economic (lack of health education, lack of available supports) and environmental.
An individual identified as being at elevated risk of a fall due to one or a combination of the above risk factors should check-in with a qualified health care professional or, preferably, a multi-disciplinary team of professionals, for a comprehensive risk analysis and intervention strategy. Interventions may include education on use of protective equipment/assistive devices, adjustments to medication(s), education regarding fall prevention strategies and/or exercise programmes designed to improve/maintain strength, posture, movement patterns (particularly walking) and balance.
It may also be helpful to identify fall recovery strategies, including making sure that there are opportunities to practice transfers (in particular from lying prone or supine to kneeling/all-fours and from kneeling/all-fours to standing) in a variety of positions and locations.
Exercise Recommendations for Fall Prevention
When starting an exercise program, it is best to seek guidance from a qualified professional (such as a Registered Kinesiologist or appropriately-certified Personal Trainer). That said, there are a number of standard recommendations that may be helpful:
• The ACSM (American College of Sports Medicine) and Canadian Society for Exercise Physiology (CSEP) have issued Position Stands recommending a minimum of 150 min/week of moderate to vigorous aerobic exercise.
• Research appears to show that improved muscle size and strength can be achieved by training the major muscle groups 2-3 days per week, with 28-72 hours rest between.
• Osteoporosis Canada (2012) recommends multiple blocks of
10-20 minute balance training (including, potentially, activities such as yoga or tai chi) sessions 2-3 days per week, for a total of at least 120 minutes per week in order to improve balance.
In the event you or someone close to you may be at risk of falls or has already fallen, a comprehensive approach to health care, risk assessment and fall prevention (including strength, aerobic and balance training) can make the difference between a fall being an uncomfortable, temporary inconvenience and a life-changing emergency situation.
Brian Fehst is a Registered Kinesiologist currently practicing as Health Management Coordinator at the YMCA-YWCA of Guelph. He is also involved in physical activity advocacy and professional development as a member of the Board Of Directors of the Ontario Society for Health and Fitness (OSHF) and is a proud alumnus of the University of Saskatchewan (B.Sc. ‘06) and Mount Allison University (B.Sc. ‘02). Brian welcomes connections with other professionals and participants and can be reached by email at: [email protected]